Abstract [en]

Objective: DSM-5 somatic symptom disorder (SSD) constitutes a major change for psychosomaticmedicine and psychiatry, as well as for epidemiological research in these fields. This studyinvestigates somatic symptoms and psychological concerns among adolescents in order tosystematically explore the relevance of SSD for general adolescent populations.

Methods: A crosssectionalpopulation-based design, with a symptoms-based strategy and a symptom-andpsychological-concerns-based strategy, was used to estimate the prevalence of somatic symptomsand psychological concerns in a general adolescent population (n=2476, mean age=16 years, 49%boys, 51% girls). Somatic symptoms and psychological concerns in relation to gender, and selfreportedmedical and psychiatric conditions were investigated. The association between somaticsymptoms, psychological concerns, and functional impairment in school-, family-, peer- and physicalactivities was studied.

Results: Reporting 3+ persistent distressing somatic symptoms wassignificantly more common than reporting one or more persistent distressing somatic symptom(s)combined with serious psychological concern. The prevalence of such complaints was significantlyhigher in girls. The proportion of medical and psychiatric conditions was highest in the groupreporting 3+ persistent distressing somatic symptoms combined with serious psychological concern.Belonging to this group most significantly increased odds ratios for functional impairment.

Conclusion: For large-scale studies on SSD, results suggest the use of measures based on multiplesomatic items in combination with psychological concerns, and a methodologically soundstandardized measure of functional impairment. To further enhance clinical decision-making, therelation of symptoms to functional impairment, and the substantial overlap of SSD with medical andpsychiatric conditions during adolescence should be addressed.